Individual
MR. BRIAN RANDOLPH WOODARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
113 CASSELL DR, KINGSPORT, TN 37660-3775
(423) 246-7240
Mailing address
4731 WOODCLIFF DR, KINGSPORT, TN 37664-4667
(423) 288-2751
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1566
TN
Other
Enumeration date
03/15/2007
Last updated
07/08/2007
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